The incidence of unpleasant dreams after sub-anaesthetic ketamine.
BACKGROUND
Ketamine is an N-methyl-D: -aspartate (NMDA) receptor antagonist with psychotogenic effects and for which there are diverse reports of whether pleasant or unpleasant dreams result during anaesthesia, post-operatively or after sub-anaesthetic use.


OBJECTIVE
To assess in healthy volunteers the incidence of unpleasant dreams over the three nights after receiving a sub-anaesthetic dose of ketamine, in comparison to placebo, and with retrospective home nightmare frequency as a covariate.


METHODS
Thirty healthy volunteers completed questionnaires about retrospective home dream recall and were then given either ketamine (n = 19, males = 9, mean age = 23.5 years; mean ketamine blood plasma = 175.29 ng/mL) or placebo (n = 11, males = 5, mean age = 25.4 years). Dream recall and pleasantness/unpleasantness of dream content were recorded by questionnaire at home for the three nights after infusion.


RESULTS
Ketamine resulted in significantly more mean dream unpleasantness relative to placebo and caused a threefold increase in the odds ratio for the incidence of an unpleasant dream. The number of dreams reported over the three nights did not differ between the groups. The incidence of unpleasant dreams after ketamine use was predicted by retrospectively assessed nightmare frequency at home.


CONCLUSIONS
Ketamine causes unpleasant dreams over the three post-administration nights. This may be evidence of a residual psychotogenic effect that is not found on standard self-report symptomatology measures or a result of disturbed sleep electrophysiology.
Blagrove
Mark
M
Department of Psychology, Swansea University, Swansea, SA2 8PP, UK. m.t.blagrove@swansea.ac.uk
Morgan
Celia J A
CJ
Curran
H Valerie
HV
Bromley
Leslie
L
Brandner
Brigitte
B
D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004325:Dreams / Q000187:drug effects*; D004644:Emotions / Q000187:drug effects; D018691:Excitatory Amino Acid Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D007649:Ketamine / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D011939:Mental Recall; D016017:Odds Ratio; D011569:Psychiatric Status Rating Scales; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors*; D018570:Risk Assessment; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000139:chemically induced* / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
D018691:Excitatory Amino Acid Antagonists; D016194:Receptors, N-Methyl-D-Aspartate; D007649:Ketamine